BACKGROUND Complete and simplified Selvester QRS score have been proposed as valuable clinical tool for estimating myocardial damage in patients with ST-elevation myocardial infarction (STEMI). We sought to comprehensively compare both scoring systems for the prediction of myocardial and microvascular injury assessed by cardiac magnetic resonance (CMR) imaging in patients with acute STEMI. METHODS In this prospective observational study, 201 revascularized STEMI patients were included. Electrocardiography was conducted at a median of 2 (interquartile range 1-4) days after the index event to evaluate the complete and simplified QRS scores. CMR was performed within 1 week and 4 months thereafter to determine acute and chronic infarct size (IS) as well as microvascular obstruction (MVO). RESULTS Complete and simplified QRS score showed comparable predictive value for acute (area under the curve (AUC) = 0.64 vs. 0.67) and chronic IS (AUC = 0.63 vs. 0.68) as well as for MVO (AUC = 0.64 vs. 0.66). Peak high sensitivity cardiac troponin T (hs-cTnT) showed an AUC of 0.88 for acute IS and 0.91 for chronic IS, respectively. For the prediction of MVO, peak hs-cTnT represented an AUC of 0.81. CONCLUSIONS In reperfused STEMI, complete and simplified QRS score displayed comparable value for the prediction of acute and chronic myocardial as well as microvascular damage. However, both QRS scoring systems provided inferior predictive validity, compared to peak hs-cTnT, the clinical reference method for IS estimation.

中文翻译：

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在ST抬高型心肌梗死中对梗死严重程度进行评估的完整和简化的Selvester QRS评分。

背景技术已提出完整和简化的Selvester QRS评分作为评估ST抬高型心肌梗死（STEMI）患者心肌损伤的有价值的临床工具。我们试图全面比较两种评分系统，以通过对急性STEMI患者进行心脏磁共振（CMR）成像评估来预测心肌和微血管损伤。方法在这项前瞻性观察研究中，纳入了201例血运重建的STEMI患者。在指标事件发生后的2天（四分位间距1-4）中位数进行心电图检查，以评估完整和简化的QRS评分。此后1周和4个月内进行了CMR，以确定急性和慢性梗死面积（IS）以及微血管阻塞（MVO）。结果完整和简化的QRS评分显示出对急性（曲线下面积（AUC）= 0.64 vs. 0.67）和慢性IS（AUC = 0.63 vs. 0.68）和MVO（AUC = 0.64 vs. 0.66）的预测价值相当。峰值高敏性心肌肌钙蛋白T（hs-cTnT）的急性IS的AUC为0.88，慢性IS的AUC为0.91。对于MVO的预测，峰hs-cTnT表示AUC为0.81。结论在再灌注STEMI中，完整和简化的QRS评分在预测急性和慢性心肌以及微血管损害方面具有可比的价值。但是，与峰值hs-cTnT（IS估计的临床参考方法）相比，两个QRS评分系统均提供较差的预测有效性。68）以及MVO（AUC = 0.64 vs. 0.66）。峰值高敏性心肌肌钙蛋白T（hs-cTnT）的急性IS的AUC为0.88，慢性IS的AUC为0.91。对于MVO的预测，峰hs-cTnT表示AUC为0.81。结论在再灌注STEMI中，完整和简化的QRS评分在预测急性和慢性心肌以及微血管损害方面具有可比的价值。但是，与峰值hs-cTnT（IS估计的临床参考方法）相比，两个QRS评分系统均提供较差的预测有效性。68）以及MVO（AUC = 0.64 vs. 0.66）。峰值高敏性心肌肌钙蛋白T（hs-cTnT）的急性IS的AUC为0.88，慢性IS的AUC为0.91。对于MVO的预测，峰hs-cTnT表示AUC为0.81。结论在再灌注STEMI中，完整和简化的QRS评分在预测急性和慢性心肌以及微血管损害方面具有可比的价值。但是，与峰值hs-cTnT（IS估计的临床参考方法）相比，两个QRS评分系统均提供较差的预测有效性。完整和简化的QRS评分在预测急性和慢性心肌以及微血管损害方面具有可比的价值。但是，与峰值hs-cTnT（IS估计的临床参考方法）相比，两个QRS评分系统均提供较差的预测有效性。完整和简化的QRS评分在预测急性和慢性心肌以及微血管损害方面具有可比的价值。但是，与峰值hs-cTnT（IS估计的临床参考方法）相比，两个QRS评分系统均提供较差的预测有效性。